- Design
- Multicentre, open-label RCT
- Population
- 169 ventilated adults with sepsis or respiratory failure, South Korea
- Primary outcome
- FSS-ICU at ICU discharge
- Effect
- 23.6 vs 22.2 (P = 0.44); no difference at 12 months
EVER randomised 169 adults with sepsis or respiratory failure expected to need invasive ventilation for 48 hours or more, at five South Korean tertiary hospitals, to a structured six-step early mobilisation programme or usual care. It was open-label and published in Intensive Care Medicine in August.
The programme delivered what it intended: mobilisation started earlier (median 30 vs 46 hours), with more sessions (11 vs 4) and more minutes (330 vs 120). But the Functional Status Score for the ICU at discharge was similar (23.6 vs 22.2). Quality of life, cognition and post-intensive care syndrome measures improved equally in both groups over 12 months. Patients who reached sit-to-stand or beyond scored higher, but that comparison is not randomised.
Early mobilisation remains reasonable, but a protocol that simply adds sessions did not move outcomes. Those able to progress further may be healthier to begin with.
- Continue mobilising ventilated patients as tolerated; this trial does not show harm.
- Do not expect a protocol alone to improve long-term function.
- Focus on sedation minimisation and delirium prevention, which enable mobilisation.
- Plan follow-up for post-intensive care syndrome.
Why it matters
It questions whether more structured mobilisation, rather than better-selected mobilisation, changes recovery.
Don't overread it
The better scores with higher mobilisation steps are a non-randomised comparison.
The statistics, in plain English
With 169 patients and unequal groups, the trial could miss a modest benefit. The higher scores in patients reaching step 4 compare them with matched controls, not with those randomised, so they may reflect patient fitness rather than the programme.
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